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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION MUSTANG?; STENTS, DRAINS AND DILATORS FOR THE BILIARY DUCTS

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BOSTON SCIENTIFIC CORPORATION MUSTANG?; STENTS, DRAINS AND DILATORS FOR THE BILIARY DUCTS Back to Search Results
Model Number H74939171052010
Medical Device Problem Code Failure to Deflate (4060)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/08/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that balloon failure to deflate occurred.The target lesion was located in the superficial femoral artery.A 5.0 x 200, 135cm mustang balloon catheter was advanced for dilation.During the procedure, the balloon was advanced and inflated to 16 atmospheres.Attempts to deflate the balloon were unsuccessful, and it remained inflated for 5 minutes while still inside the patient.The balloon was removed together with the introducer in a single movement and the procedure completed using an alternate method.There were no patient complications as a result of this event.
 
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Brand Name
MUSTANG?
Common Device Name
STENTS, DRAINS AND DILATORS FOR THE BILIARY DUCTS
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
pmt 741 persiaran cassia selat
bandarcassia, pulau pinan 14110
MY   14110
Manufacturer Contact
rachel shields
4100 hamline ave n
arden hills, MN 55112
6512422111
MDR Report Key22702099
Report Number2124215-2025-53143
Device Sequence Number18388994
Product Code FGE
UDI-Device Identifier08714729793373
UDI-Public(01)08714729793373(17)270716(10)34439138
Combination Product (Y/N)N
Initial Reporter CountryCO
PMA/510(K) Number
K103751
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 08/04/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Model NumberH74939171052010
Device Catalogue NumberH74939171052010
Device Lot Number0034439138
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/08/2025
Initial Report FDA Received Date08/04/2025
Date Device Manufactured07/16/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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